Retinal migraine, also called ophthalmic migraine or ocular migraine, is a serious condition needing thorough medical evaluation. If you experience any of the symptoms of retinal migraine, you must consult your doctor even if the symptoms subside on their own.
Treatment mainly focuses on preventing recurrence rather than aborting the attack because the vision loss subsides on its own. Treatment largely depends on the frequency of attacks and the underlying causes, which may include:
- Lifestyle modifications: Avoiding stress, getting adequate sleep, avoiding alcohol and caffeine, smoking cessation, drinking sufficient water to prevent dehydration, and managing a healthy weight can help. Eating meals on time and including healthy nutritious foods helps prevent low blood sugar levels and maintain overall health. Your doctor may ask you to stop taking certain medications, such as hormonal contraceptives.
- Medications: Medications could be administered to treat underlying health conditions, such as high blood pressure. Calcium channel blockers are generally preferred to prevent blood vessel spasm that triggers a retinal migraine. They include drugs, such as verapamil and nifedipine. Medications, such as ergot-derivatives, triptans, and beta-blockers, that are generally used in migraine are avoided in retinal migraine. Other medications that may be prescribed include nonsteroidal anti-inflammatory drugs, aspirin, antidepressants, and anticonvulsants.
20 triggers of retinal migraine
A retinal migraine occurs due to a transient spasm (narrowing) of the arteries supplying blood to the tissues of the eye (choroidal or retinal arteries). This spasm results in reduced blood supply leading to vision loss.
Some conditions can trigger a retinal migraine attack in susceptible individuals, such as:
- Bright lights
- Low blood sugar due to skipping meals or eating too little
- Sleep deprivation
- Sleeping too much
- Hypertension (high blood pressure)
- High altitude
- Hot weather
- Hormonal changes in females, such as around menopause or periods
- Strong odors
- Rigorous physical activity or exercise
- Certain movements, such as bending over
- Excess alcohol consumption, particularly red wine
- Excess caffeine intake
- Straining at stools
- Sexual intercourse
- Hormonal birth control pills
- Certain foods, such as aged cheese, soy products, monosodium glutamate, and chocolates (although common triggers for migraine, these foods rarely play a role in triggering retinal migraine)
What are the symptoms of retinal migraine?
The vision loss generally lasts for a few minutes to an hour and is associated with minimal or no headache. The affected person may describe it as gradual vision disturbances that may begin as blind spots or scotomas in the field of vision. These scotomas then slowly enlarge leading to total unilateral vision loss.
The affected person may report seeing twinkling lights or scintillations before the onset of vision loss. Although retinal migraine typically causes temporary vision loss, in some cases, repeated attacks may lead to a permanent loss of vision.
Vision disturbances may occur during a migraine aura. Unlike retinal migraine, the vision changes of a migraine aura affect both the eyes. They may perturb with activities, such as reading or writing, and prove dangerous if the person is driving when the aura initiates.
The vision changes, however, are not serious and go away on their own. They may be experienced as:
- Zigzag patterns
- Flashes of light
- Shimmering spots
- Blind spots in the field of vision
There could be other migraine aura symptoms, such as:
Al Khalili Y, Jain S, King KC. Retinal Migraine Headache. [Updated 2022 Jan 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507725/
Mayo Clinic. Ocular migraine: When to seek help. https://www.mayoclinic.org/diseases-conditions/migraine-headache/expert-answers/ocular-migraine/faq-20058113
American Migraine Foundation. Retinal Migraine: Symptoms, Causes and Treatment. https://americanmigrainefoundation.org/resource-library/retinal-migraine/
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